Which statement best differentiates Illness Anxiety Disorder from Somatic Symptom Disorder?

• A. Illness Anxiety Disorder requires multiple comorbid personality disorders.
• B. Somatic Symptom Disorder requires no somatic symptoms.
• C. Both disorders require identical levels of somatic symptom burden.
• D. Illness Anxiety Disorder centers on health anxiety with minimal somatic symptoms, while Somatic Symptom Disorder centers on distressing, persistent somatic symptoms with disproportionate thoughts/behaviors about them.

Answer: (D)

Distinguishing illness-focused health anxiety from actual somatic symptoms is the key idea. Illness Anxiety Disorder centers on preoccupation with having or acquiring a serious illness, with little to no somatic symptoms, and persistent health-related anxiety even after medical reassurance. Somatic Symptom Disorder, on the other hand, involves one or more actual somatic symptoms that are distressing or disrupt daily life, along with excessive thoughts, feelings, or behaviors about those symptoms that are disproportionate to their seriousness.

The emphasis here is the presence and weight of bodily symptoms: Illness Anxiety Disorder has minimal somatic symptoms and the worry is about illness itself, whereas Somatic Symptom Disorder centers on real, persistent somatic symptoms and a disproportionate response to them.

Other statements don’t fit diagnostic criteria: somatic symptom disorder requires somatic symptoms; illness anxiety disorder does not depend on comorbid personality disorders; and the two disorders do not share identical levels of somatic burden. This contrast is exactly what differentiates the two.